Demographic distribution
A total of 92 responses were received; 41 (44.6%) were male, with 29 (31.5%) aged 18-22 years, 48 (52.2%) aged 23-27 years, 10 (10.9%) aged 28-32 years, 4 (4.3%) aged 33-37 years, and 1 (1.1%) aged 38-42 years (Table 1). A total of 40 (43.5%) of the respondents were studying at Adelaide University, 22 (23.9%) were studying at Griffith University, and 30 (32.6%) were studying at James Cook University. Among the respondents, 89 (96.7%) had been enabled by their universities to undertake a rural clinical placement, and 39 (42.4%) had ever lived in a rural area for more than a year (Table 1).
Reason for applying for rural placement
Overall most respondents strongly agreed that a rural clinical placement would provide them with a wider range of clinical skills (Figure 1). When comparing gender, age groups, and those from either regional or urban dental schools, mean scores were different, but not significantly so. Reasons for applying for rural placement were (from highest to lowest): for enhancing job prospects upon graduation (2.6, sd1.1); for experiencing rural life (2.6, sd1.2); for improving dental health of people in such areas (2.3, sd1.1); for increasing clinical skills (2.2, sd1.2); and for getting exposure to a wider range of clinical treatments (2.1, sd1.3) (Table 2). No significant differences were found in the responses of those participants who had ever, compared to never, lived in a rural location for at least a year.
Preparation for rural placement
The majority of respondents agreed that they were adequately prepared for a rural placement (Figure 1), with an average score of 2.4 (sd1.1) (Table 2). This did not vary significantly across students of different genders, age groups, university locations, or previous experience of rural living (Table 2).
Competition for employment
The majority of respondents strongly agreed that they will enter a highly competitive job market (Figure 2), with an average score of 1.7 (sd1.1) (Table 3). This response did not vary significantly across students of different genders, age groups, university types, and previous rural habitation (Figure 2, Table 3). There was support for this view in the open text responses, as some respondents stated that “it is not a level playing field” when some graduates rely on having family associations with the profession, which could help them to obtain employment.
Employment preference
Most respondents strongly agreed that they preferred to be fully employed in one dental clinic location rather than being partly employed in multiple dental clinic locations (Figure 2)(mean score 2; sd1.63) (Table 3). The mean score obtained for the students from the urban-based university was higher (2.2, sd1.2) than that for the students from the two rural-based universities (1.8, sd1.1), but the difference was not statistically significant (Table 3).
Most students agreed that the rural placement would enable them to make a better choice as to where they would prefer to work. This is more pronounced for students from the urban-based universities than for the rural universities (2.4, sd 1.0 versus 2.2, sd 1.0, p>0.05) (Table 3).
City employment only
Most respondents disagreed with the proposition that they wanted to work in the city only (mean score 3.4, sd 1.1) (Figure 2 and Table 3). This did not differ significantly between gender, age, urban/non-urban dental school, and previous rural habitation groups. However, students from rural-based universities more strongly disagreed that they wanted to only work in a city, compared to urban-based students (3.6, sd 1.1 versus 3.1, sd 1.1; p>0.05) (Table 3).
Prefer Rural Employment
The average response to this question of rural employment preference was neutral (mean score 2.9, sd 1.0) (Figure 2 and Table 3). Those students who had lived previously in a rural area indicated a greater preference to work in a rural area (2.7,sd 1.0) than those who had not lived in a rural location (3.1, sd 1.0). The mean score obtained was higher amongst students from urban-based than rural-based universities (3.0, sd 0.9 versus 2.8,sd1.0; p>0.05) (Table 3).
Qualitative responses
The final part of this survey asked respondents to make a personal comment about their rural clinical placements. A response rate of 30% was acheived for this part of the survey. Most of these responses were positive and made mention of the greater range in dental treatments provided, the increase in clinical time available (4.5 days as opposed to 1.5 days), more clinical variety and scope of treatments, different mentorships and guidance by other dental students, making professional contacts for possible future employment opportunities, the greater degree of patient appreciation for their treatments, and the ability to be part of a rural community and to enjoy the experience.
Some negative responses included loss of time with family, for example parents, partners, and in some cases, children. There was also dissatisfaction with some universities which were perceived as charging their students too much for unacceptable accommodation and making the cost of rural placement too high. Some students pointed to travel and living costs, which were not being subsidised by some of the universities. Some mention was made of perceived government bureaucracy in placing limitations on patient clinical management.